Cy­to­ki­net­ic­s' come­back at­tempt with sec­ond-gen mus­cle drug is slammed by a PhII fail­ure in ALS

John Carroll

Editor & Founder

Sev­en­teen months af­ter Cy­to­ki­net­ics’ lead mus­cle drug crashed and burned in a Phase III ALS tri­al, their $CYTK sec­ond-gen at­tempt has now gone down to de­feat in a Phase II tri­al.

Robert Blum

This new drug, relde­sem­tiv, has been billed by CEO Robert Blum as a “more po­tent, more pen­e­tra­ble” drug for treat­ing mus­cle wast­ing in pa­tients. While their drug tirasem­tiv strug­gled and failed in treat­ing ALS pa­tients be­cause of the nec­es­sar­i­ly dose-lim­it­ing as­pects of the ther­a­py, he said, relde­sem­tiv would be free to punch in a high­er weight class.

It didn’t work.

In a Phase II tri­al re­port­ed out on Sun­day, in­ves­ti­ga­tors said their study failed on change from base­line in slow vi­tal ca­pac­i­ty (SVC) af­ter 12 weeks of dos­ing (p=0.11). The analy­sis al­so shows poor p val­ues for ALS­FRS-R and slope of the Mus­cle Strength Mega-Score.

The biotech’s shares dropped about 20% in ear­ly trad­ing Mon­day. But the com­pa­ny man­aged to turn that around, end­ing the day in the green af­ter mak­ing its case for the drug.

The South San Fran­cis­co-based biotech’s re­lease on Sun­day ac­knowl­edges the fail­ure up front, then goes on to list the rea­sons why the com­pa­ny nev­er­the­less be­lieves the da­ta are ac­tu­al­ly quite good, jus­ti­fy­ing more tri­al work.

Their case rests on a post hoc analy­sis, which tend to be ig­nored by in­vestors un­hap­py with a set­back like this. Ac­cord­ing to the re­searchers, the da­ta re­flect “clin­i­cal­ly mean­ing­ful mag­ni­tudes of ef­fect” across all dose lev­els. They al­so main­tain that the place­bo group de­clined at a slow­er rate than ex­pect­ed, which didn’t help.

“Re­sults from FOR­TI­TUDE-ALS are among the most im­pres­sive we have seen in a Phase II clin­i­cal tri­al in ALS,” boast­ed lead in­ves­ti­ga­tor Je­re­my Shefn­er. “Es­pe­cial­ly note­wor­thy are the con­sis­ten­cy and dura­bil­i­ty of ef­fects ob­served across treat­ment arms on clin­i­cal­ly mean­ing­ful end­points.”

This isn’t the first time Cy­to­ki­net­ics — part­nered with Astel­las — has tout­ed weak or failed da­ta. Last sum­mer Blum scoffed at my ques­tions about relde­sem­tiv’s fail­ure to re­main clin­i­cal­ly sig­nif­i­cant at week 8 af­ter hit­ting the mark at week 4.

“That’s with­in the noise of sta­tis­tics this size,” he said. “We don’t see that as a ta­per­ing.”

Al­most ex­act­ly 5 years ago tirasem­tiv al­so failed a Phase IIb tri­al for ALS, but it didn’t stop the biotech from in­sist­ing that the drug war­rant­ed a Phase III.

Cy­to­ki­net­ics’ shares closed Fri­day at $8.85, around the same lev­el it’s been tread­ing wa­ter at since the Phase III dis­as­ter.

Jason Mast

Associate Editor

Legend Biotech, the Nanjing-based CAR-T developer, has raised $424 million on NASDAQ. The biotech had originally filed for a still-hefty $350 million, based on a range of $18-$20, but managed to fetch $23 per share, allowing them to well-eclipse the massive raises from companies like Allogene, Juno, Galapagos, though they’ll still fall a few dollars short of Moderna’s record-setting $600 million raise from 2018.

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Is a pow­er­house Mer­ck team prepar­ing to leap past Roche — and leave Gilead and Bris­tol My­ers be­hind — in the race to TIG­IT dom­i­na­tion?

John Carroll

Editor & Founder

Roche caused quite a stir at ASCO with its first look at some positive — but not so impressive — data for their combination of Tecentriq with their anti-TIGIT drug tiragolumab. But some analysts believe that Merck is positioned to make a bid — soon — for the lead in the race to a second-wave combo immuno-oncology approach with its own ambitious early-stage program tied to a dominant Keytruda.

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As it hap­pened: A bid­ding war for an an­tibi­ot­ic mak­er in a mar­ket that has rav­aged its peers

Natalie Grover

Reporter

In a bewildering twist to the long-suffering market for antibiotics — there has actually been a bidding war for an antibiotic company: Tetraphase.

It all started back in March, when the maker of Xerava (an FDA approved therapy for complicated intra-abdominal infections) said it had received an offer from AcelRx for an all-stock deal valued at $14.4 million.

The offer was well-timed. Xerava was approved in 2018, four years after Tetraphase posted its first batch of pivotal trial data, and sales were nowhere near where they needed to be in order for the company to keep its head above water.

Recursion Pharmaceuticals

Salt Lake City, UT

John Carroll

Editor & Founder

Lonza chairman Albert Baehny took his time headhunting a new CEO for the company, making it absolutely clear he wanted a Big Pharma or biotech CEO with a good long track record in the business for the top spot. In the end, he went with the gold standard, turning to Roche’s ranks to recruit Pierre-Alain Ruffieux for the job.

Ruffieux, a member of the pharma leadership team at Roche, spent close to 5 years at the company. But like a small army of manufacturing execs, he gained much of his experience at the other Big Pharma in Basel, remaining at Novartis for 12 years before expanding his horizons.

Natalie Grover

Reporter

Amber Tong

Editor

Jason Mast

Associate Editor

Another Big Pharma is entering the Covid-19 antibody hunt.

AbbVie has announced a collaboration with the Netherlands’ Utrecht University and Erasmus Medical Center and the Chinese-Dutch biotech Harbour Biomed to develop a neutralizing antibody that can treat Covid-19. The antibody, called 47D11, was discovered by AbbVie’s three partners, and AbbVie will support early preclinical work, while preparing for later preclinical and clinical development. Researchers described the antibody in Nature Communicationslast month.

Pfiz­er’s Doug Gior­dano has $500M — and some ad­vice — to of­fer a cer­tain breed of 'break­through' biotech

John Carroll

Editor & Founder

So let’s say you’re running a cutting-edge, clinical-stage biotech, probably public, but not necessarily so, which could see some big advantages teaming up with some marquee researchers, picking up say $50 million to $75 million dollars in a non-threatening minority equity investment that could take you to the next level.

Doug Giordano might have some thoughts on how that could work out.

The SVP of business development at the pharma giant has helped forge a new fund called the Pfizer Breakthrough Growth Initiative. And he has $500 million of Pfizer’s money to put behind 7 to 10 — or so — biotech stocks that fit that general description.

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Can a small biotech suc­cess­ful­ly tack­le an Ever­est climb like Alzheimer’s? Athi­ra has $85M and some in­flu­en­tial back­ers ready to give it a shot

John Carroll

Editor & Founder

There haven’t been a lot of big venture rounds for biotech companies looking to run a Phase II study in Alzheimer’s.

The field has been a disaster over the past decade. Amyloid didn’t pan out as a target — going down in a litany of Phase III failures — and is now making its last stand at Biogen. Tau is a comer, but when you look around and all you see is destruction, the idea of backing a startup trying to find complex cocktails to swing the course of this devilishly complicated memory-wasting disease would daunt the pluckiest investors.

New York, NY

GSK presents case to ex­pand use of its lu­pus drug in pa­tients with kid­ney dis­ease, but the field is evolv­ing. How long will the mo­nop­oly last?

Natalie Grover

Reporter

In 2011, GlaxoSmithKline’s Benlysta became the first biologic to win approval for lupus patients. Nine years on, the British drugmaker has unveiled detailed positive results from a study testing the drug in lupus patients with associated kidney disease — a post-marketing requirement from the initial FDA approval.

Lupus is a drug developer’s nightmare. In the last six decades, there has been just one FDA approval (Benlysta), with the field resembling a graveyard in recent years with a string of failures including UCB and Biogen’s late-stage flop, as well as defeats in Xencor and Sanofi’s programs. One of the main reasons the success has eluded researchers is because lupus, akin to cancer, is not just one disease — it really is a disease of many diseases, noted Al Roy, executive director of Lupus Clinical Investigators Network, an initiative of New York-based Lupus Research Alliance that claims it is the world’s leading private funder of lupus research, in an interview.

UP­DAT­ED: Es­ti­mat­ing a US price tag of $5K per course, remde­sivir is set to make bil­lions for Gilead, says key an­a­lyst

Natalie Grover

Reporter

Data on remdesivir — the first drug shown to benefit Covid-19 patients in a randomized, controlled trial setting — may be murky, but its maker Gilead could reap billions from the sales of the failed Ebola therapy, according to an estimate by a prominent Wall Street analyst. However, the forecast, which is based on a $5,000-per-course US price tag, triggered the ire of one top drug price expert.

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